Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2012; 18(25): 3317-3321
Published online Jul 7, 2012. doi: 10.3748/wjg.v18.i25.3317
Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease
Marlene Gallegos, Dawn Bradly, Shriram Jakate, Ali Keshavarzian
Marlene Gallegos, Department of Pathology, University of California, Irvine, Orange, CA 92868, United States
Dawn Bradly, Shriram Jakate, Department of Pathology, Rush University Medical Center, Chicago, IL 60612, United States
Ali Keshavarzian, Department of Gastroenterology, Rush University Medical Center, Chicago, IL 60612, United States
Author contributions: Gallegos M, Bradly D, Jakate S and Keshavarzian A contributed equally to this work; Gallegos M, Jakate S and Keshavarzian A contributed to concept, design, analysis and literature review; Gallegos M, Bradly D, Keshavarzian A, and Jakate S contributed to revision and reporting of the cases; Gallegos M, Bradly D and Jakate S examined and reviewed the pathologic findings of all cases.
Correspondence to: Marlene Gallegos, MD, Department of Pathology, University of California, Irvine, Orange, CA 92868, United States. marlene_gallegos@rush.edu
Telephone: +1-714-4566141 Fax: +1-714-4565873
Received: April 7, 2011
Revised: May 17, 2011
Accepted: May 12, 2012
Published online: July 7, 2012
Abstract

There has been an increasing prevalence of lymphogranuloma venereum (LGV) or Chlamydia trachomatis (C. trachomatis) cases among the men who have sex with men (MSM) population, particularly in Europe and North America. These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome. During the initial evaluation and colonoscopy, there is a strong clinical and endoscopic suspicion of inflammatory bowel disease (IBD) by virtue of presentation and endoscopic and histological findings. The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire: (1) there is failure of response to IBD therapy; (2) additional components of history (MSM/travel) may be identified; (3) return of initially performed Chlamydia antibody test is positive; and (4) response to antibiotics effective against Chlamydia. We describe three such cases initially suspected to be an inflammatory bowel disease and subsequently identified as C. trachomatis proctosigmoiditis.

Keywords: Lymphogranuloma venereum, Chlamydia trachomatis, Proctitis, Proctosigmoiditis, Men who have sex with men, Crohn’s disease, Inflammatory bowel disease